This invention relates to surgical instruments and, more specifically, to an attachment for a standard surgical bone cutting (osteotomy) saw.
For wounds resulting in a tearing away (avulsion) of bony structure, reconstructive surgery, bone implants, and/or grafts are needed to restore bone continuity. Furthermore, the majority of patients who undergo reconstructive facial surgery require partial or complete dentures (dental prostheses). For a dental prosthesis to fit and function properly in the mouth, there must be a successful reconstruction of a bony base ample enough to support the prosthesis. As discussed below, use of the invention will substantially increase the chances for successful reconstructive surgery in these cases.
Under current surgical procedures and technology, when a surgeon removes (ablates) a section of bone from the human body during reconstructive surgery, he or she will use a standard motor or power pack such as a nitrogen driven ZIMMER reciprocating saw. A single surgical saw blade will be attached.
Obviously, to remove a length of diseased (morbid) bone with a single bladed surgical saw will require two cuts with a measurement between them to ensure that the correct length of bone is removed. Sometimes the measurement is inaccurate and, frequently, the second cut is not parallel to the first. If a bone implant or graft is to be inserted into the host site where the diseased bone was removed, and the lengths of the site and the implant/graft do not precisely match and/or the bone walls are not exactly parallel, the complete, continuous host-graft contact which is needed for "graft-take" will be missing.
The need to make multiple cuts and measurements engendered by a single bladed surgical saw also impacts on the length of operations. Use of such a configured saw in multiple osteotomies, in particular, will substantially extend operating time.
There is an additional problem encountered when bone is cut during a surgical procedure. The heat generated by the cutting action of the saw through the bone, if above 47.degree. C., induces bone cell death (necrosis). This can result in post-surgical bone morbidity, pain and inflammation of the bone (osteomyelitis).
Surgical instruments do exist which address, in part and piecemeal, some of the problems associated with bone surgery described above. However, no one device addresses all of these problems in a simple, lightweight, easy to use attachment as does the claimed invention. While both U.S. Pat. Nos. 1,660,015 and 2,179,250 describe devices which can make simultaneous parallel surgical bone cuts, neither has a means for cooling the bone-saw interface during the cutting operation. Furthermore, both use circular blades which together with the cumbersome nature of their design make both inappropriate for use in surgical sites around the small and delicate upper facial (maxillofacial) bones. Finally, both are powered by electric motors which cannot be used in today's operating rooms.
U.S. Pat. No. 3,640,280 shows a reciprocating surgical saw containing cooling means. However, this device cannot make parallel cuts. Furthermore, the cooling fluid is not released along the length of the saw blade and, most importantly, there is no provision for the cooling means to pivot as the surgical cuts are made thereby keeping the water directed at the surgical site throughout the cutting operation.